关节置换术与内固定术治疗不稳定粗隆间骨折的效果比较
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摘要
目的探讨关节置换术与内固定术治疗不稳定粗隆间骨折(UIF)患者的效果。方法选择2017年2月～2018年3月我院治疗的125例UIF患者,按照随机数字表法分为观察组和对照组,观察组63例患者实施关节置换术治疗,对照组62例患者实施内固定术治疗,比较两组患者的手术时间、术中出血量、髋关节功能(Harris)评分及视觉模拟评分(VAS)情况。结果观察组患者的手术时间以及术中出血量均低于对照组,差异均有统计学意义(P<0.05);治疗后,观察组患者的Harris评分优良率为92.00%,高于对照组的74.19%,组间比较差异有统计学意义(P<0.05);观察组患者术后12、24、48和72 h的VAS指标评分均低于对照组,差异均有统计学意义(P<0.05)。结论关节置换术治疗UIF的疗效良好,值得推广。
Objective To investigate the efficacy of joint replacement and internal fixation in the treatment of unstable intertrochanteric fractures(UIF). Methods 125 patients with UIF as the research object from February 2017 to March 2018 in our hospital,according to the method of random numbers were divided into observation group and control group,63 patients in the observation group were given joint replacement treatment,62 cases of control group were given internal fixation treatment,operation time,intraoperative blood loss,Harris and VAS score of two groups were compared. Results Observation group of patients with operative time and intraoperative blood loss were lower than the control group(P<0.05).After treatment,the observation group of patients with Harris score was 92.00% higher than that 74.19% of the control group(P<0.05).The VAS scores index of observation group in postoperative 12,24,48 and 72 h were lower than the control group(P<0.05). Conclusion The joint replacement is effective in treating UIF.
Objective To investigate the efficacy of joint replacement and internal fixation in the treatment of unstable intertrochanteric fractures(UIF). Methods 125 patients with UIF as the research object from February 2017 to March 2018 in our hospital,according to the method of random numbers were divided into observation group and control group,63 patients in the observation group were given joint replacement treatment,62 cases of control group were given internal fixation treatment,operation time,intraoperative blood loss,Harris and VAS score of two groups were compared. Results Observation group of patients with operative time and intraoperative blood loss were lower than the control group(P<0.05).After treatment,the observation group of patients with Harris score was 92.00% higher than that 74.19% of the control group(P<0.05).The VAS scores index of observation group in postoperative 12,24,48 and 72 h were lower than the control group(P<0.05). Conclusion The joint replacement is effective in treating UIF.
引文
[1] 张建立.关节置换术与内固定术在治疗老年不稳定粗隆间骨折的临床效果观察[J].中国处方药,2018,16(3):135-136.
[2] 赵智浩.人工关节置换与内固定在股骨转子间骨折患者中的应用[J].中国校医,2018,32(2):85-86.
[3] 董明,解传信,江乐健,等.关节置换术与内固定术在治疗老年不稳定粗隆间骨折的临床效果观察[J].当代医学,2017,23(31):124-125.
[4] Camurcu Y,Cobden A,Sofu H,et al.What Are the Determinants of Mortality After Cemented Bipolar Hemiarthroplasty for Unstable Intertrochanteric Fractures in Elderly Patients[J].J Arthroplasty,2017,32(10):3038-3043.
[5] 张超凡,张文明,黄子达,等.人工髋关节置换术与内固定术治疗老年不稳定股骨粗隆间骨折的Meta分析[J].中国骨与关节损伤杂志,2015,30(10):1035-1039.
[6] 冼敬锋.全髋关节置换术与骨折内固定术治疗中老年股骨颈骨折的疗效分析[J].重庆医学,2013,42(13):1528-1529.
[7] 高文.双极半关节置换与内固定治疗老年不稳定型粗隆间骨折疗效比较[J].山东医药,2013,53(48):47-49.
[8] Yoo JI,Ha YC,Lim JY,et al.Early Rehabilitation in Elderly after Arthroplasty versus Internal Fixation for Unstable Intertrochanteric Fractures of Femur:Systematic Review and Meta-Analysis[J].J Korean Med Sci,2017,32(5):858-867.
[9] Zhang H,Xu Z,Zhou A,et al.Efficacy of Kirschner-wires and tension band in hip arthroplasty for aged patients with unstable intertrochanteric osteoporotic fracture:A 2-to-11-year follow-up[J].Medicine (Baltimore),2017,96(1):5614-5615.
[10] Shi Y,Chen Z J,Hong Z Y,et al.Case-control study on retaining articular capsule in the total hip replacement for old patients with unstable femoral neck fractures[J].Zhongguo Gu Shang,2016,29(11):989-993.
[11] Chang JD,Kim I S,Lee SS,et al.Unstable intertrochanteric versus displaced femoral neck fractures treated with cementless bipolar hemiarthroplasty in elderly patients;a comparison of 80 matched patients[J].Orthop Traumatol Surg Res,2016,102(6):695-699.
[2] 赵智浩.人工关节置换与内固定在股骨转子间骨折患者中的应用[J].中国校医,2018,32(2):85-86.
[3] 董明,解传信,江乐健,等.关节置换术与内固定术在治疗老年不稳定粗隆间骨折的临床效果观察[J].当代医学,2017,23(31):124-125.
[4] Camurcu Y,Cobden A,Sofu H,et al.What Are the Determinants of Mortality After Cemented Bipolar Hemiarthroplasty for Unstable Intertrochanteric Fractures in Elderly Patients[J].J Arthroplasty,2017,32(10):3038-3043.
[5] 张超凡,张文明,黄子达,等.人工髋关节置换术与内固定术治疗老年不稳定股骨粗隆间骨折的Meta分析[J].中国骨与关节损伤杂志,2015,30(10):1035-1039.
[6] 冼敬锋.全髋关节置换术与骨折内固定术治疗中老年股骨颈骨折的疗效分析[J].重庆医学,2013,42(13):1528-1529.
[7] 高文.双极半关节置换与内固定治疗老年不稳定型粗隆间骨折疗效比较[J].山东医药,2013,53(48):47-49.
[8] Yoo JI,Ha YC,Lim JY,et al.Early Rehabilitation in Elderly after Arthroplasty versus Internal Fixation for Unstable Intertrochanteric Fractures of Femur:Systematic Review and Meta-Analysis[J].J Korean Med Sci,2017,32(5):858-867.
[9] Zhang H,Xu Z,Zhou A,et al.Efficacy of Kirschner-wires and tension band in hip arthroplasty for aged patients with unstable intertrochanteric osteoporotic fracture:A 2-to-11-year follow-up[J].Medicine (Baltimore),2017,96(1):5614-5615.
[10] Shi Y,Chen Z J,Hong Z Y,et al.Case-control study on retaining articular capsule in the total hip replacement for old patients with unstable femoral neck fractures[J].Zhongguo Gu Shang,2016,29(11):989-993.
[11] Chang JD,Kim I S,Lee SS,et al.Unstable intertrochanteric versus displaced femoral neck fractures treated with cementless bipolar hemiarthroplasty in elderly patients;a comparison of 80 matched patients[J].Orthop Traumatol Surg Res,2016,102(6):695-699.